Shaming didn’t work to get men to wear condoms during the early days of the AIDS epidemic, but making condom-wearing convenient and less unpleasant was effective. The same lessons need to be applied to mask-wearing today.
Julia Marcus at The Atlantic:
Public-health professionals have learned this lesson before. In 1987, Congress banned the use of federal funds for HIV-prevention campaigns that might “promote or encourage, directly or indirectly, homosexual activities.” As a result, public-health campaigns avoided sex-positive imagery and messaging, and instead associated condom use with virtue and condomless sex with irresponsibility, disease, and death. According to one particularly foreboding poster, which featured an image of a gravestone: “A bad reputation isn’t all you can get from sleeping around.” But those moralistic, fear-mongering health messages often fell flat. Other HIV-prevention campaigns began to adopt a harm-reduction approach, which empathizes with people’s basic human needs and offers them strategies to limit potential dangers. For some men, condoms got in the way of what they valued most about sex: pleasure and intimacy. Not surprisingly, HIV-prevention campaigns that put pleasure and intimacy at the center of their safer-sex messaging tended to work.
When the public-health community talks about harm reduction, we often talk of “meeting people where they are.” A fundamental part of that is, well, literally meeting people where they are. Just like the buckets of free condoms stationed in gay bars, masks need to be dispensed where they’re needed most: at the front of every bus and the entrance to every airport, grocery store, and workplace. Masks should become ubiquitous, but distribution should begin in areas where the coronavirus has hit hardest, including black and Latino neighborhoods. (That black men who wear masks may be at heightened risk of violence is one more grim illustration of why combatting racism is inextricable from public health.) What matters most is that people choose to wear a mask when they are indoors or in close proximity to others—and that choice needs to be rendered as effortless as possible.
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